Blunted Hypercapnic Respiratory Drive Response in Subjects With Late-Onset Pompe Disease.

BACKGROUND: Patients with Iate-onset Pompe disease develop progressive hypercapnic respiratory failure that can be disproportionate to the respiratory muscle compromise and/or thoracic restriction. Although recent studies have reported the presence of a blunted hypercapnic respiratory response in so...

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Publicado en:Respiratory Care Vol. 61; no. 7; pp. 930 - 936
Autores principales: De Vito, Eduardo L., Monteiro, Sergio G., Aruj, Patricia K.
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Jul2016
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Mary Ann Liebert, Inc.
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        atl: Blunted Hypercapnic Respiratory Drive Response in Subjects With Late-Onset Pompe Disease.
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        au:
          De Vito, Eduardo L.
          Monteiro, Sergio G.
          Aruj, Patricia K.
        affil: Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
      sug:
        subj:
          Glycogen Storage Disease Complications
          Carbon Dioxide Blood
          Respiratory Failure Physiopathology
          Respiratory Muscles
          Muscle Strength Evaluation
          Expiration
          Inspiration, Respiratory
          Airway Pressure
          Blood Gas Analysis
          Arteries
          Descriptive Statistics
          Data Analysis Software
          P-Value
          T-Tests
          Mann-Whitney U Test
          Fisher's Exact Test
          Case Control Studies
          Capnography
          Human
          Female
          Male
          Adult
          Middle Age
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: BACKGROUND: Patients with Iate-onset Pompe disease develop progressive hypercapnic respiratory failure that can be disproportionate to the respiratory muscle compromise and/or thoracic restriction. Although recent studies have reported the presence of a blunted hypercapnic respiratory response in some subjects with neuromuscular disorders and chronic hypercapnia, no study has evaluated the integrity of the respiratory drive in subjects with late-onset Pompe disease. Thus, we endeavor to determine the CO2 rebreathing response in subjects with late-onset Pompe disease. METHODS: Respiratory muscle strength was assessed by measuring the maximum inspira tory pressure, and the maximum expiratory pressure. The maximum inspiratory pressure reflects the strength of the diaphragm and other inspiratory muscles, whereas the maximum expiratory pressure reflects the strength of the abdominal muscles and other expiratory muscles. We studied the hypercapnic drive response (measured as the ratio of the change in airway-occlusion pressure 0.1 s after the start of inspiration and end-tidal P... in 13 subjects with late-onset Pompe disease and 51 healthy controls. RESULTS: Overall inspiratory muscle strength was within normal limits or slightly diminished in the late-onset Pompe disease group. Five subjects (38.5%) were chronically hypercapnic, and 9 (69.2%) had an increased breath-holding time. Compared with controls, the change in airway-occlusion pressure 0.1 s/change in end-tidal CO2 pressure slope (hypercapnic respiratory drive) was lower in the late-onset Pompe disease group (median 0.050 [interquartile range 0.027-0.118] vs 0.183 [0.153-0.233], P < .001). Nine subjects (69.2%) had a blunted change in airway-occlusion pressure 0.1 s/change in end-tidal carbon dioxide pressure slope. CONCLUSIONS: Subjects with late-onset Pompe disease had an impaired hypercapnic respiratory drive response. The clinical impact of this phenomenon in this subject subset deserves further investigation.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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